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Diagnostic accuracy of computed tomography to identify adenomas among adrenal incidentalomas in an endocrinological population

dc.rights.licenseopenen_US
dc.contributor.authorMARTY, M.
dc.contributor.authorGAYE, D.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorPEREZ, Paul
dc.contributor.authorAUDER, C.
dc.contributor.authorNUNES, M. L.
dc.contributor.authorFERRIERE, A.
dc.contributor.authorHAISSAGUERRE, M.
dc.contributor.authorTABARIN, A.
dc.date.accessioned2020-12-07T10:12:03Z
dc.date.available2020-12-07T10:12:03Z
dc.date.issued2018-05
dc.identifier.issn0804-4643en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/21319
dc.description.abstractEnCONTEXT: The recent recommendations of the European Endocrine Society states that the performance of computed tomography (CT) to characterize 'true' adrenal incidentalomas (AIs) remains debatable. OBJECTIVE: To determine relevant thresholds for usual CT parameters for the diagnosis of benign tumors using robust reference standard among a large series of 'true' AIs recruited in an endocrinological setting. DESIGN: Retrospective study of 253 AIs in 233 consecutive patients explored in a single university hospital: 183 adenomas, 33 pheochromocytomas, 23 adrenocortical carcinomas, 5 other malignant tumors and 9 other benign tumors. Reference standard was histopathology in 118 AIs, biological diagnosis of pheochromocytoma in 2 AIs and size stability after at least 1 year of follow-up in 133 AIs. METHODS: Sensitivity, specificity and positive and negative predictive values were estimated for various thresholds of size, unenhanced attenuation (UA), relative and absolute wash-out (RPW, APW) of contrast media. 197 scans were reviewed independently in a blinded fashion by two expert radiologists to assess inter-observer reproducibility of measurements. RESULTS: Criteria associated with a 100% positive predictive value for the diagnosis of benign AI were: a combination of size and UA: 30 mm and 20 HU or 40 mm and 15 HU, respectively; RPW >53%; and APW >78%. Non-adenomatous AIs with rapid contrast wash-out were exclusively benign pseudocysts and pheochromocytomas, suggesting that classical thresholds of 60% and 40% for APW and RPW, respectively, can be safely used for patients with normal metanephrine values. Inter-observer reproducibility of all parameters was excellent (intra-class correlation coefficients: 0.96-0.99). CONCLUSIONS: Our study, the largest conducted in AIs recruited in an endocrinological setting, suggests safe thresholds for quantitative CT parameters to avoid false diagnoses of benignity.
dc.language.isoENen_US
dc.subject.enUSMR
dc.subject.enCIC1401
dc.title.enDiagnostic accuracy of computed tomography to identify adenomas among adrenal incidentalomas in an endocrinological population
dc.title.alternativeEur J Endocrinolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1530/eje-17-1056en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29467231en_US
bordeaux.journalEuropean journal of endocrinologyen_US
bordeaux.page439-446en_US
bordeaux.volume178en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue5en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamUSMRen_US
bordeaux.teamCIC1401en_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03043247
hal.version1
hal.date.transferred2020-12-07T10:12:08Z
hal.exporttrue
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